The vision of this roadmap is to provide guidance to European policymakers, funders, and the scientific and clinical communities regarding priority research, infrastructure development, and education and training actions related to medical applications of ionising radiation (IR). Proposed actions are prioritised regarding their impact on patients’ life expectancy and/or quality of life, radiation protection as an integral part of quality and safety measures, and healthcare systems as well as their feasibility, providing time frames and cost estimations. The roadmap builds on the challenges and research needs identified in the EURAMED rocc-n-roll Strategic Research Agenda and also takes into account the European funding landscape for health and digital innovation, as well as actions carried out within the scope of the Strategic Agenda for Medical IR Applications (SAMIRA), to drive progress in personalised medicine using medical applications of IR in Europe.